Bubonic plague is one of three life-threatening diseases caused by Yersinia pestis (Y. pestis), a bacteria found in small animals and their fleas. If left untreated, bubonic plague can be fatal; however, it can be easily treated with antibiotics. (1) The bacteria can then travel through the lymphatic system and result in swollen lymph nodes, or buboes, from which bubonic plague gets its name. These will usually develop in and around the groin, armpits, and neck. Other symptoms, which tend to develop within three to seven days of the initial infection, include the following:
FeverChillsWeaknessAchesNauseaVomiting
Y. pestis can also enter your body if your skin is broken and you come into contact with an infected animal’s blood. The risk of contracting bubonic plague is very low, but it can increase depending on where you live, what you do for a living, and your recreational pastimes. Rural areas that have a high number of rodents, for example, are at a higher risk for bubonic plague. Cases in the United States are rare but tend to occur in Western and Southwestern states. If you work outdoors or with animals, this could also put you at an increased risk, as can hunting and camping where plague-infected critters live. (2) Buboes may remain for several weeks after treatment, possibly longer if you have a severe case or develop septicemic or pneumonic plague. (5)
Prognosis of Bubonic Plague
If untreated, the prognosis is poor, with mortality rates estimated at 50 to 90 percent. (6) In the United States, the overall mortality rate is 11 percent. (3)
Medication Options
Bubonic plague can usually be successfully treated with various antibiotics:
gentamicin (Garamycin)streptomycinlevofloxacin (Levaquin)ciprofloxacin (Cipro)doxycycline (Vibramycin)moxifloxacin (Avelox)
Prevention of Bubonic Plague
Unfortunately, there is no vaccine available to protect you from bubonic plague. If you think you’ve been exposed to it, antibiotics can be taken to prevent infection. You won’t have to be quarantined, but care will need to be taken to ensure that the infection doesn’t spread from you to others through tissue, blood, or other fluids. (3) In addition, you may want to take the following precautions: (7)
Rodent-proof your home. Get rid of areas where rodents may nest, such as piles of brush and firewood. Avoid leaving food where rodents can access it.Wear gloves. If you must handle a potentially infected animal, wear gloves to prevent contact between your skin and the bacteria.Use insect repellent. DEET-containing products can protect you from rodent fleas when you’re hiking, camping, or working outdoors.Keep pets flea-free. Apply flea-control products to your pets regularly.
Septicemic plague occurs when the bacteria multiply in your bloodstream. In addition to the symptoms of bubonic plague, septicemic plague can cause the following:
Abdominal painSeptic shock (a life-threatening condition in which the vital organs of the body stop working due to infection spreading throughout the body)Diarrhea and vomitingBleedingGangrene (death of body tissue due to lack of blood flow), usually in extremities such as your nose, fingers, and toes
Pneumonic plague is the least common type of plague, but it’s the most dangerous because it can be spread via cough droplets from person to person. Pneumonic plague causes the following symptoms:
CoughShortness of breathChest painBloody sputum (a mixture of saliva and mucus produced when you cough)High feverExtreme weakness
As it progresses, pneumonia from plague can cause respiratory failure and shock. If not treated by antibiotics within 24 hours of symptoms, it can be fatal. Bubonic plague can affect people of any age, but 50 percent of reported cases occur in people between 12 and 45 years old. It occurs in both men and women but is slightly more common in men. (8) Between 1965 and 2012, people who identified as American Indians represented a much larger number of cases — 33 percent — compared with previous years. (9) With additional reporting by Carlene Bauer.
